McNiel Melinda E, Labbok Miriam H, Abrahams Sheryl W
University of North Carolina School of Medicine, Charlotte 28209, USA.
Breastfeed Rev. 2010 Jul;18(2):25-32.
Most infant feeding studies present infant formula use as 'standard' practice, supporting perceptions of formula feeding as normative and hindering translation of current research into counseling messages supportive of exclusive breastfeeding. To promote optimal counseling, and to challenge researchers to use exclusive breastfeeding as the standard, we have reviewed the scientific literature on exclusive breastfeeding and converted reported odds ratios to allow discussion of the 'risks' of any formula use.
Studies indexed in PubMed that investigated the association between exclusive breastfeeding and otitis media, asthma, types 1 and 2 diabetes, atopic dermatitis, and infant hospitalization secondary to lower respiratory tract diseases were reviewed. Findings were reconstructed with exclusive breastfeeding as the standard, and levels of signidicance calculated.
When exclusive breastfeeding is set as the normative standard, the re-calculated odds ratios communicate the risks of any formula use. For example, any formula use in the first 6 months is significantly associated with increased incidence of otitis media (OR: 178, 95% CI: 1.19, 2.70 and OR: 4.55, 95% CI: 1.64, 12.50 in the available studies; pooled OR for any formula in the first 3 mo: 2.00, 95% CI: 140, 2.78). Only shorter durations of exclusive breastfeeding are available to use as standards for calculating the effect of 'any formula use' for type 1 diabetes, asthma, atopic dermatitis, and hospitalization secondary to lower respiratory tract infections.
Exclusive breastfeeding is an optimal practice, compared with which other infant feeding practices carry risks. Further studies on the influence of presenting exclusive breastfeeding as the standard in research studies and counseling messages are recommended.
大多数婴儿喂养研究将婴儿配方奶粉的使用视为“标准”做法，这强化了配方奶喂养是常态的观念，阻碍了将当前研究转化为支持纯母乳喂养的咨询信息。为了促进最佳咨询，并促使研究人员将纯母乳喂养作为标准，我们回顾了关于纯母乳喂养的科学文献，并转换了报告的比值比，以便讨论任何配方奶使用的“风险”。
对在PubMed上索引的研究进行了回顾，这些研究调查了纯母乳喂养与中耳炎、哮喘、1型和2型糖尿病、特应性皮炎以及下呼吸道疾病继发的婴儿住院之间的关联。以纯母乳喂养为标准重新构建研究结果，并计算显著性水平。
当将纯母乳喂养设定为规范标准时，重新计算的比值比传达了任何配方奶使用的风险。例如，在头6个月使用任何配方奶都与中耳炎发病率增加显著相关（在现有研究中，OR：1.78，95%CI：1.19，2.70；OR：4.55，95%CI：1.64，12.50；头3个月使用任何配方奶的合并OR：2.00，95%CI：1.40，2.78）。对于1型糖尿病、哮喘、特应性皮炎以及下呼吸道感染继发的住院情况，只有较短时间的纯母乳喂养可作为计算“任何配方奶使用”效果的标准。
与其他婴儿喂养方式相比，纯母乳喂养是一种最佳做法，其他方式存在风险。建议进一步研究在研究和咨询信息中以纯母乳喂养为标准的影响。
